EFFECT OF STRUCTURED IN-SERVICE TRAINING ON NURSES’ KNOWLEDGE, PRACTICE, AND SELF-CONFIDENCE REGARDING PATIENTS’ COLOSTOMY CARE

Elgazzar, Samia Eaid; Elkashif, Mirfat Mohamed Labib; Eltahry, Sheren Ibrahim; Ibrahim, Ateya Megahed; Shahin, Mahmoud Abdel Hameed

doi:10.1590/1980-265X-TCE-2024-0072en

Brasil

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Original Article • Texto contexto - enferm. 33 • 2024 • https://doi.org/10.1590/1980-265X-TCE-2024-0072en linkcopy

EFFECT OF STRUCTURED IN-SERVICE TRAINING ON NURSES’ KNOWLEDGE, PRACTICE, AND SELF-CONFIDENCE REGARDING PATIENTS’ COLOSTOMY CARE

EFECTO DE LA CAPACITACIÓN ESTRUCTURADA EN SERVICIO SOBRE EL CONOCIMIENTO, PRÁCTICA Y AUTOCONFIANZA DE LOS ENFERMEROS RESPECTO AL CUIDADO DE PACIENTES CON COLOSTOMÍA

EFEITO DO TREINAMENTO ESTRUTURADO EM SERVIÇO NO CONHECIMENTO, PRÁTICA E AUTOCONFIANÇA DOS ENFERMEIROS EM RELAÇÃO AO CUIDADO DE PACIENTES COM COLOSTOMIA

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: To determine the impact of structured in-service training on nurses’ knowledge, practice, and self-confidence regarding caring for patients with colostomy.

Method: Utilizing a one-group pretest-posttest quasi-experimental study design, the study was conducted in the oncology department at Egypt Health Care Authority hospitals in Port Said governorate (Elmabra Hospital) and the oncology institute in Damietta City. From October 2023 to January 2024, 50 nurses from the oncology departments of the two cities in Egypt participated in the study to assess their knowledge, practice, and self-confidence before and after exposure to in-service training about colostomy care. Data analysis was carried out using descriptive, correlational, and inferential statistics.

Results: Implementation of Structured In-service Training significantly improved nurses’ total knowledge scores, practice scores, and self-confidence levels (p ≤ 0.05). Notably, a more robust positive correlation emerged after training between nurses’ knowledge and practice, knowledge and self-confidence, and practice and self-confidence (r=0.757, r=0.738, and r=0.619, respectively). However, the correlations were significant before the training program as well.

Conclusion: The study underscores a critical necessity for nurses to concentrate on the specialized field of colostomy care by establishing a routine in-service training system. Further research is warranted to validate the findings of this investigation.

DESCRIPTORS: Colostomy care; In-service training; Nurses' knowledge; Nurses' practice; Nurses' self-confidence; Nursing education

Variable	No. (%)
Age
20 - < 30 years	47(94.0)
30 - < 40 years	3(6.0)
≥ 40 years	0(0.0)
Mean ± SD.	25.64 ± 3.58
Qualification
Nursing Diploma	16(32.0)
Nursing Technical Institute	25(50.0)
Bachelor of Nursing	9(18.0)
Previous years of training courses about colostomy
Less than one year	0 (0)
one - < 5 years	23(46.0)
5 - < 10 years	24(48.0)
≥ ten years	3(6 .0)
Take advantage of the courses.
No	45(90.0)
Medium	5(10.0)
Years of Experience
1-10 years	47(94.0)
11-20 years	3(6.0)

Knowledge	Mean scores (mean ± SD)		Test of Sig.	p§
Knowledge	Before training	After training	Test of Sig.	p§
Knowledge about colostomy
Min. - Max.	8.0 - 11.0	8.0 - 10.0	Z¶=1.277	0.202
Mean ± SD.	9.10 ± 0.95	9.22 ± 0.65	Z¶=1.277	0.202
Knowledge about the colostomy bag
Min. - Max.	0.0 - 2.0	1.0 - 2.0	Z=2.178^*	0.029^*
Mean ± SD.	1.60 ± 0.67	1.84 ± 0.37	Z=2.178^*	0.029^*
Knowledge about the prevention of skin problems
Min. - Max.	0.0 - 3.0	1.0 - 4.0	Z=3.644^*	<0.001^*
Mean ± SD.	1.50 ± 0.81	2.28 ± 0.97	Z=3.644^*	<0.001^*
Knowledge about diet
Min. - Max.	1.0 - 2.0	2.0 - 3.0	Z=6.208^*	<0.001^*
Mean ± SD.	1.80 ± 0.40	2.84 ± 0.37	Z=6.208^*	<0.001^*
knowledge about activities
Min. - Max.	0.0 - 2.0	0.0 - 1.0	Z=3.135^*	0.002^*
Mean ± SD.	0.70 ± 0.65	0.30 ± 0.46	Z=3.135^*	0.002^*
Total knowledge of nurses
Min. - Max.	12.0 - 18.0	14.0 - 19.0	Z=4.840^*	<0.001^*
Mean ± SD.	14.70 ± 1.69	16.48 ± 1.50	Z=4.840^*	<0.001^*

Practice	Mean scores (mean ± SD)		Test of Sig.	p§
Practice	Before training	After training	Test of Sig.	p§
Empty, clean, and reuse the bag.
Min. - Max.	12.0 - 17.0	16.0 - 17.0	Z¶=4.105^*	<0.001^*
Mean ± SD.	15.20 ± 1.68	16.46 ± 0.50	Z¶=4.105^*	<0.001^*
Stoma irrigation
Min. - Max.	3.0 - 14.0	12.0 - 14.0	Z=5.063^*	<0.001^*
Mean ± SD.	10.30 ± 3.26	13.04 ± 0.60	Z=5.063^*	<0.001^*
Applying a new pouch
Min. - Max.	9.0 - 17.0	16.0 - 17.0	Z=4.256^*	<0.001^*
Mean ± SD.	14.10 ± 2.91	16.44 ± 0.50	Z=4.256^*	<0.001^*
Total practice of nurses
Min. - Max.	30.0 - 48.0	44.0 - 47.0	Z=5.083^*	<0.001^*
Mean ± SD.	39.60 ± 6.66	45.94 ± 1.15
Median	40.50	46.0

Q	Nurse Self-confidence	Mean ± SD.
Q	Nurse Self-confidence	Before training	After training
	Knowledge statement: I feel confident
1	Knowing the difference between colostomy, ileostomy, and urostomy	2.00 ± 0.00	3.72 ± 0.99
2	Prevention of skin problems	2.56 ± 0.50	3.80 ± 1.01
3	Dealing with the odor	2.36 ± 0.48	3.78 ± 0.93
4	When to attach to a larger drainage bag if needed	1.84 ± 0.58	3.76 ± 1.02
5	Ordering the correct supplies	2.58 ± 0.50	5.14 ± 1.07
6	Dealing with peristomal skin problems	2.16 ± 0.65	4.46 ± 0.93
7	Knowledge of nutrition for patients with ostomies	2.34 ± 0.48	4.16 ± 1.13
	Practice Statement: I feel confident
8	Emptying an ostomy appliance	2.42 ± 0.67	3.90 ± 0.95
9	Changing an ostomy appliance	1.88 ± 0.63	3.90 ± 0.99
10	Cutting the wafer to the appropriate size	2.36 ± 0.48	5.06 ± 1.22
11	Measuring the stoma	2.12 ± 0.63	5.04 ± 1.19
12	Applying the paste, if needed	2.22 ± 0.42	3.86 ± 0.90
13	How to attach to a larger drainage bag, if needed	2.42 ± 0.64	4.56 ± 0.91

Nurse’s self-confidence	Mean scores (mean ± SD)		Test of Sig.	p§
Nurse’s self-confidence	Before training	After training	Test of Sig.	p§
Knowledge statement: I feel confident
Min. - Max.	14.0 - 18.0	23.0 - 36.0	t‡=26.01^*	<0.001^*
Mean ± SD.	15.84 ± 1.39	28.84 ± 3.11	t‡=26.01^*	<0.001^*
Skill statement: I feel confident
Min. - Max.	10.0 - 16.0	17.0 - 32.0	t=23.433^*	<0.001^*
Mean ± SD.	13.42 ± 1.39	26.32 ± 3.42	t=23.433^*	<0.001^*
Total nurse’s self-confidence
Min. - Max.	25.0 - 32.0	40.0 - 68.0	t=28.039^*	<0.001^*
Mean ± SD.	29.26 ± 1.96	55.16 ± 5.99	t=28.039^*	<0.001^*

Correlation		Before training	After training
Knowledge VS. Practice	r_s †	0.527^*	0.757^*
Knowledge VS. Practice	p	<0.001^*	<0.001^*
Knowledge VS. Nurse’s Self-confidence	r_s	0.465^*	0.738^*
Knowledge VS. Nurse’s Self-confidence	P	0.001^*	<0.001^*
Practice VS. nurse’s self-confidence	r_s	0.326^*	0.619^*
Practice VS. nurse’s self-confidence	p	0.021^*	<0.001^*

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[TFN1] ¶: Wilcoxon signed-rank test (Z-test); §: p-value for comparing the Pre and Post; *: Statistically significant at p ≤ 0.05